机械通气治疗肾移植术后巨细胞病毒性肺炎合并急性呼吸窘迫综合征的疗效分析

Evaluation of mechanical ventilation for patients with acute respiratory distress syndrome caused by cytomegalovirus pneumonia after renal transplantation

目的探讨机械通气在治疗肾移植术后巨细胞病毒肺炎合并急性呼吸窘迫综合征中的价值。方法14例肾移植术后cMV肺炎合并ARDS患者，在早期抗病毒治疗、调整免疫抑制方案等综合治疗措施的基础上，全部给予机械通气治疗，观察其疗效。结果14例患者中9例有效，有效率为64．2％，5例死亡，死亡率为35．8％。14例患者治疗后2小时、12小时、24小时、48小时及72小时的动脉血氧分压、氧合指数及呼吸频率较治疗前均有改善（均为P〈0．01）。结论机械通气可在短时间内纠正缺氧保证氧合，为治疗原发病赢得时间，在治疗肾移植后CMV合并ARDS患者的治疗中具有重要的意义。

Objective To evaluate the clinical value of mechanical ventilation for patients with acuterespiratory distress syndrome（ARDS） caused by cytomegalovirus （CMV） pneumonia after renal transplantation. Methods A total of 14 cases of ARDS caused by CMV pneumonia after renal transplantation were studied retrospectively. Mechanical ventilation was applied in all the 14 patients on base of combined therapy, clinical effect were observed. Results Nine cases recovered and five cased died, death rate were 35.8%.The PaO2 ,PaO2 /FiO2 and the breath rate Were improved in all patients after mechanical ventilation 2 hours, 12 hours, 24 hours, 48 hours and 72 hours. Conclusions The mechanical ventilation was important to treat patient with ARDS caused by CMV pneumonia after kidney transplantation because it could correct hypoxemia quickly and ensure oxygen pressure in artery blood in order to win time to cure primary disease.